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Author
Topic: HIV hides in gut to escape attack (Read 8259 times)

HIV is able to survive drug attack by hiding out in the gut lining, US scientists have discovered. Even when blood tests suggested antiretroviral treatment was working, the virus continued to replicate in the gut, suppressing immune function.

Writing in the Journal of Virology, the authors recommend earlier, aggressive drug treatment to combat this.

The University of California team also suggest monitoring patients with gut biopsies as well as blood tests.

Theirs is the first study to show that, while current HIV therapy is quite successful in reducing viral loads and increasing the number of immune T-cells to fight the infection in peripheral blood, it is not so effective in gut mucosa.

The gut is acting as a viral reservoir that keeps us from ridding patients of the virus

Lead researcher Dr Satya Dandekar

Dr Satya Dandekar and her team followed 10 patients being treated with highly active antiretroviral therapy, known as HAART.

They took blood and gut samples from the patients before and after three years of treatment. Three of the patients had been treated very early, within four to six weeks of first being infected with the virus, whereas the others had been infected for at least a year before receiving treatment.

The patients who had been treated earlier had fewer signs of gut inflammation before treatment and experienced greater recovery of the gut mucosal immune system function after treatment than the other patients.

Viral reservoir

Dr Dandekar explained: "We found a substantial delay in the time that it takes to restore the gut mucosal immune system in those with chronic infections.

"In these patients the gut is acting as a viral reservoir that keeps us from ridding patients of the virus."

She said the results suggested anti-inflammatory drugs might improve antiretroviral treatment outcomes and that genes involved with the repair and regeneration of the gut mucosal immune system would make excellent drug targets.

A spokeswoman from the HIV charity AVERT said: "This research offers an enlightening insight into one of the ways that HIV evades drugs in the body, and if further studies show that anti-inflammatory drugs improve the efficacy of antiretrovirals, they could prove a very useful addition to HIV therapy.

"However, the researchers' suggestion of starting HIV treatment earlier will need to be weighed up against the risk of earlier drug resistance forming, and the difficulties of drug toxicity and side effects before it is considered for adoption as standard medical practice."

Mary Lima, a treatment specialist at the Terrence Higgins Trust, agreed. She said: "At this stage we have to be cautious as starting treatment earlier, taking anti-inflammatory drugs and having gut biopsies would put an additional burden on people living with HIV.

"However, it's really important that research into this area continues so we can understand more about HIV and how it could be treated in future."

Anyway, could this turn out to be the real culprit, the reservoir for chronic infection? Imagine if it turns out to be this simple, develop a drug regime that targets the virus hiding in the gut and bingo, you're cured...time will tell I suppose.

« Last Edit: August 05, 2006, 01:38:31 AM by J220 »

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"Hope is my philosophy Just needs days in which to beLove of Life means hope for meBorn on a New Day" - John David

You know, statements like that frustrate me. What do you think we are doing? Wasting time?

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NB. Any advice about HIV is given in addition to your own medical advice and not intended to replace it. You should never make clinical decisions based on what anyone says on the internet but rather check with your ID doctor first. Discussions from the internet are just that - Discussions. They may give you food for thought, but they should not direct you to do anything but fuel discussion.

Regardless, it's a fact. And the statement can be read in a variety of ways, for example, it can be meant as a comment on how insidious the virus is, while it can also be meant in the content that yes, researchers have been incompetently behind the curve for all these years. It's all in the eye of the beholder. But for the record, I did mean it in the latter sense.

J.

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"Hope is my philosophy Just needs days in which to beLove of Life means hope for meBorn on a New Day" - John David

We thank you for your kind comments. Despite the fact that the techniques that led to this discovery were only invented recently and weren't available or thought of 25 years ago. I don't know what people think scientists do but sitting in the office twddling thumbs or playing keystone cops with test tubes it ain't. What's the point of looking for a cure if people just think you are stupid and wasting time. I'd happily give up my place in science if you or anyone else think you could do it better or faster.

My eyes saw your comment for what it was. Given the way it was put it could hardly mean the former.

R

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NB. Any advice about HIV is given in addition to your own medical advice and not intended to replace it. You should never make clinical decisions based on what anyone says on the internet but rather check with your ID doctor first. Discussions from the internet are just that - Discussions. They may give you food for thought, but they should not direct you to do anything but fuel discussion.

All those I know that include the ones who made this discovery and why it took so long.

R

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NB. Any advice about HIV is given in addition to your own medical advice and not intended to replace it. You should never make clinical decisions based on what anyone says on the internet but rather check with your ID doctor first. Discussions from the internet are just that - Discussions. They may give you food for thought, but they should not direct you to do anything but fuel discussion.

But I don't understand something, from what I read, this was just a matter of collecting and analyzing GALT samples. What was the technique discovered that made this possible? Was it the testing, or the collecting? Or was it just the idea of looking for a 'reservoir' in the gut? Didn't anyone think about this before, especially in lght of the fact that, as the original article states, GALT accounts for 70% of the body's immune system? Seems to me that considering the nature of the disease this would have been a logical place to look at, in my opinion, J.

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"Hope is my philosophy Just needs days in which to beLove of Life means hope for meBorn on a New Day" - John David

R , this isn't an attack on you but you have to admit with the past record many with HIV are just plain cynical. In fact watching public TV where they were talking about large pharmas, almost all the breakthroughs that made these companies rich were over 20 years ago.

This being an obvious one-

Quote

as the original article states, GALT accounts for 70% of the body's immune system?

.Not saying you as I suspect that there are many different groups doing different things in looking at how the virus functions, but if this is part of basic immune biology why then did it take 25 years to figure out the relationship? if anything it points to what many people with the virus think be it true or not , that like oil as long as we are maintained on drugs to keep us alive we will pay anything and thus keep the goose laying its golden eggs.

Again as a lay person I am ignorant so

Quote

Despite the fact that the techniques that led to this discovery were only invented

can you tell us ignorami what those were?

Please don't take this as an attack but a chance to enlighten us on what is going on. It is too bad more researchers and medical personal deeply involved in HIV aren't hear to clear up some myths we have.

Btw way did you watch the PBS special on AIDS. What I came away with that it was interesting the whole ego trip at WHO which seemed to correlate with the renewed spike in HIV.

written in bonhomie

Cheers Johnny - and I hope your feeling better.

« Last Edit: August 05, 2006, 07:52:47 PM by alisenjafi »

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"You shut your mouthhow can you sayI go about things the wrong wayI am human and I need to be lovedjust like everybody else does"The Smiths

I know I am not supposed to post post anything in these forums since I am not yet 100% sure of my status...(forgive me Ann)However I thought this was important to resolve the sad bickering, which unfortunately could be fully understood weighing 2 sides of the argument.I did the search for "major organs of the immune system" and this came up.

No mentioninng of the gut tissue. So does that mean in addition to GALT, we will have to target liver, bone marrow etc to restore the immune system?Or do current therapies do it very well? And the brain? Thats the major viral reservoir. Right?

PS: On the more personal note, this recent discovery does explain why several days after the possible infection my stomach was unusually active for no reason, as though some heavy battle was going on there, for about a week before every MONO symptom kicked in.

...one other thing that could lift spirits is this link. Which among other techniques listed will tackle with the virus in the gut. Hmm, so it was known then that the gut is a viral reservoir, prior to the BBC article. Anyhow, it is great news that we have privatly funded organizations that are dedicated to making HIV/AIDS a thing of the past.

T79, I thank you for being positive about this thread but it just irked me the wrong way. In my experience in science, the beauty of how the body works can seem simple with the genius of hindsight. The final solution to the problem of HIV will be simple - so simple we will wonder how we never thought of it. I'm not knocking J220 for his open thoughts about the state of HIV science, nor do I think his ideas are without merit. But what is simple on paper turns out to be several years of scientific work. All we have to do is zap the latent pool, drain the persistent pool and identify where the virus can replicate in the presence of drugs. A simple idea to put on an internet forum but quite different to actually pick the pipettes up and do.

I have read the criticism of science on this forum many many times and taken what was said on the chin. I've even been accused of not being a scientist because I spend time on this forum - and what scientist would do that. Or so the argument goes. I don't disagree that mistakes have been made and the state of funding is horrible. I agree that more could be done - but when can we ever sit down and say, "Everything possible that could be done - was!" ?

I am many things in real life, and thin skinned is one of them. I accept that and I try to work on it. Maybe I shouldn't take such comments like, the ones above to heart - but I do. And I'll tell you I do too. What am I to do when people suggest that scientists merely don't care about HIV and want to brush it under the carpet? Do I take such criticism lying down and not respond because I am not in a position to argue with someone with HIV - for that is rude?

I am proud to work on HIV - it's been a childhood dream of mine. I work bloody hard at it too and every day when I drive to work I think of people on this forum. Dream of the day that I can meet people like Jonathan in real life and actually give him something that will help. Not because I have some weird need to be loved, as someone suggested, but because it is hard to read this forum and NOT be affected by it. Not to read how Dingoboi hates his medication, how Moffie has anxiety related to viral resistance. To read collapsing T-cell counts and how people suffer the pain of the medication. I drive to work to try and change all that, to work with people who share this goal and try and push the envelope of our understanding to get that final key that will look so simple in hindsight.

So I get offended when people suggest we are stupid. I get offended when people think I am here to merely trivialize your condition and smoke a pipe in a castle thinking how clever we are to say things like pseudotype, tropism and viral uncoating.

I don't see the world from your side because I am a HIV negative man. I will never know what it is like to be HIV positive. I do see the depth of character on here and admire it. Likewise unless you spent time with me and my work associates you would maybe not agree that we are all dumb and are here just to say, "HIV is a manageable disease". I've only met one person who really meant that out of the countless I have worked with. I don't interact with medical doctors much and maybe they form part of a visible front I am blind to.

I don't promise a cure, I'm not that naive. But I do promise that I will NEVER merely sit around and blunder my way around the human body like a fool in a half-hearted attempt to find out how HIV really works. If I did, I'd leave tomorrow. From what I have seen of HIV science in my short time on this planet, very few actually do.

So criticise science if you like for not solving the key to a problem that has lasted 25 years. But the level of understanding wasn't there. Maybe people have an unrealistic view of what can and can't be done?

Maybe it is due to the fact people have said too many times, "This will lead to a cure for HIV" and people have become jaded with that message. That I would understand....as much as I would understand a battle-hard soldier rolling their eyes at the notion that the war will be over by Christmas. Afterall, all we had to do was get to Berlin and shoot Hitler. Why did that take 5 years to do?

R

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NB. Any advice about HIV is given in addition to your own medical advice and not intended to replace it. You should never make clinical decisions based on what anyone says on the internet but rather check with your ID doctor first. Discussions from the internet are just that - Discussions. They may give you food for thought, but they should not direct you to do anything but fuel discussion.

Hey R., I don't think it's unreasonable for you to take exception at this thread, while at the same time I think it gives you credit to admit that you are a bit 'thin-skinned'. Nothing wrong with that, except that if you are going to react the same way every time you see criticism on this board against researchers or pharmaceutical companies then you're in for the long haul (you have already done this on a number of occasions, inadvertently hijacking threads). You can't expect to come to this board and not see posts that are critical.

There isn't a single person here that can deny your passion for the subject matter, and we thank you for that. We certainly do not want you to become the lightning rod for any strong feelings against researchers or pharmaceutical companies. But after all we are all entitled to our opinions, and you are not required to agree with them, nor we with yours. You make some good points, and it's an interesting topic, but if you feel offended, or irked, or whatever, by content on any post that is critical of the scientific community, that doesn't entitle you to jump on whoever wrote the offending post, this borders on harassment, ironically, and I am sure that is not your intent (I think and hope). To avoid that, I would plainly suggest that you start a new thread addressing that topic, that way you can discuss it- not argue- at lenght, and others can join you, to everyone's content.

Moving on, since this thread has strayed enough as it is…you mentioned earlier that this discovery resulted from new techniques developed. Which are those? Also, is it true, to your knowledge, that GALT accounts for 70% of the immune system, and if so, since when has this been known?

Lastly, the article mentions the possible use of anti-inflammatory drugs to address the HIV in the gut, or at least its effect there (and granted, this is all very preliminary information). Following on that line, would taking substances like bismuth subsalicylate have beneficial effects in that regard, due to its anti-inflammatory action in the digestive tract? Just curious. J.

« Last Edit: August 06, 2006, 04:37:22 AM by J220 »

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"Hope is my philosophy Just needs days in which to beLove of Life means hope for meBorn on a New Day" - John David

If this disease will ever be conquered, it would be by the passionte researchers like yourself. What you've written and how you wrote it speaks volumes about your character and where you stand. You are a true humanist. And that's rare these days.Yes, I am also very skeptical of the system. It is after all capitalism where everything is for sale including human life. And as long as something is profitable (and boy does AIDS becoming a lucrative industry, projected to make 12 billion a year by the year 2012, and that's only drugs, not even mentioning the great many jobs and careers it created on which many people depend on for survival on this planet.) It's hard to remain optimistic knowing all this, but then again there are those individuals like you who genuanly care.So my hat is off to you for your work and passion! I believe that one day HIV will be history and those who made it possible will become legends and true heros. Songs will be written about them, books and movies made, Nobel prizes and whatever comes with it.Just imagine a world free of AIDS! Wow, now that's truly something.Be well! T

So I get offended when people suggest we are stupid. I get offended when people think I am here to merely trivialize your condition and smoke a pipe in a castle thinking how clever we are to say things like pseudotype, tropism and viral uncoating.

Already this thread is getting hijacked. Don't you think as a scientist that an immunologist somewhere would have looked at this in the past. If you look at the history that is still being made on HIV it more about politics and morality than it is about true science.This is where our cynicism comes from, the fact the American gov't ( or any other) didn't look to make a shock and awe attack on HIV in 80's because of the demographics.I am a awaiting my latest test results and then I will give you better picture of how someone feels about the whole trip.

Both J220 and I feel the same way and asked the same obvious questions. Your analogy about Hitler is wrong, We see it as having glaucoma and taking 25 years of seeing priests before someone realizes this has to do with an optometrist . definetly not seeing the forest for the trees!

CheersJohnny

« Last Edit: August 06, 2006, 09:37:07 AM by alisenjafi »

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"You shut your mouthhow can you sayI go about things the wrong wayI am human and I need to be lovedjust like everybody else does"The Smiths

and you are saying they didn't look because either the scientists were too stupid or that the political climate that existed and still exists excludes adequate funding for HIV - so people can't afford to ask these questions?

R

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NB. Any advice about HIV is given in addition to your own medical advice and not intended to replace it. You should never make clinical decisions based on what anyone says on the internet but rather check with your ID doctor first. Discussions from the internet are just that - Discussions. They may give you food for thought, but they should not direct you to do anything but fuel discussion.

I'll throw in a third option R., one that I personally favor: it was just simply overlooked. It doesn't necessarily have to be that researchers were 'stupid'. It's possible that in their zeal to defeat this they headed off in another direction.

In any case this whole discussion, in terms of the gut issue, is rather premature, I'm afraid. We don't even know if this truly will have a major impact on future treatment or virus-clearing regimes, although you gotta love the beauty of the possibility of helping cure HIV with Pepto Bismol! (said tongue in cheek of course).

To wrap this up (at least from my end) I think that this research, whatever it means in the end, is highly encouraging, and shows that researchers are in fact working hard to defeat this (whatever else has happaned in the past) and that surely one day THE discovery will be made that will result in a cure. And I suspect, as you stated R., that it might very well turn out to be a truly simple solution, in hindisght. Onward! J.

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"Hope is my philosophy Just needs days in which to beLove of Life means hope for meBorn on a New Day" - John David

I don't disagree, and I thank you for your candor in this post. I can comment on the third possibility and it covers something that others have touched on. After this post I will return to HIV in the gut and list some of the things that led to this discovery, the pitfalls that made it take so long, and what I feel it could do for the future. I'll stick my science hat back on.

But you bring up an interesting point regarding the direction of science. I have seen on this forum a few times a want for a central body that is dedicated to finding a cure. On paper this is a noble notion but one that is doomed to fail because of ego and capitalism. If we did have such a body, then it would be conceivable that the entire scientific community would head off on a tangent and leave something like this untouched. My argument against a central body has always been that it is too open to abuse of egos that might think they are on the right track but merely are servicing their egos. I am not for one minute going to claim the ego problem doesn't exist in science (you all probably are pointing your finger at me now) but at least it doesn't dictate direction in the manner a central body would. One of the nice things about peer reviewed science and the funding is that everyone is doing everything....and this includes looking for where HIV is replicating. It might seem random, it might seem like there is no plan, but a problem of the scale of HIV has to be tackled on ALL fronts and not just one....for the very fears you stated in your third possibility. I can't sit here and claim that we have not been down blind alleys, or that ego has not dictated research and time lost. But the problem is not as bad as has been claimed and THAT, finally, is the point I have been trying to make. Nothing more than that. That HIV research has never just all run off in one direction together because of some foolish notion. It's been done on all fronts at all times.

On the subject of HIV replication in the gut, let me add a few priming comments. It will not be the only place HIV hides, but it will be a major one. The lungs also have a large surface area and are prone to attack from OIs that can threaten the life of an HIV infected individual. At the very least, research like the ones you have listed should be moved in the direction of helping to thwart the decline of the immune system in these key areas - to make medication more tolerant and OIs less prevalent. It should serve to show that a mere carpet bombing of the body might not be the most effective strategy and as we move into the third decade of this disease we need to a more focused approach.

The way I see the HIV scientific field over the next 10 years will be defined by new classes of drugs against entry, integration, assembly and budding. Drugs with fewer side effects and more combined therapies to make it one pill, once a day. To some this might represent the scientific community resting on its laurels and not implementing a final strategy for HIV eradication. I submit that there is a need for the above therapies in the here and now. These are the things that we can do to improve the lives of those infected by HIV while we explore the gut, the lungs and the brain for the source of the replication on HAART. So I expect the news to be better drugs over the next few years - and that is research money well spent because people are suffering NOW - look at Tibotech's new PI for an example. Other research will be done on the gut in order to get everyone OFF therapy...but we won't see the fruit of that labor for some time. I can tell you as a matter of fact, however, that this is the ultimate goal.

R

« Last Edit: August 06, 2006, 03:33:38 PM by HIVworker »

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NB. Any advice about HIV is given in addition to your own medical advice and not intended to replace it. You should never make clinical decisions based on what anyone says on the internet but rather check with your ID doctor first. Discussions from the internet are just that - Discussions. They may give you food for thought, but they should not direct you to do anything but fuel discussion.